Healthcare Provider Details

I. General information

NPI: 1639000482
Provider Name (Legal Business Name): GWENDOLYN VANEGAS LCMHC-A, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 E MAIN ST
SPINDALE NC
28160-1938
US

IV. Provider business mailing address

737 E MAIN ST
SPINDALE NC
28160-1938
US

V. Phone/Fax

Practice location:
  • Phone: 704-466-0162
  • Fax:
Mailing address:
  • Phone: 704-466-0162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA22967
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: